Gangguan Trombosis pada Infeksi HIV (Human Immunodeficiency Virus) Lanjut Usia

Kadek Wisnu Segara Karya, I Ketut Agus Somia, Renny Anggreni Rena

Abstract


Thrombosis disorder in elderly patients with HIV infection is a chronic disorder that is interesting to discuss because of its multifaceted impact. Elderly patients with HIV infection face a dual risk from aging and HIV effects, which can exacerbate coagulation disorders. Thrombosis can lead to severe complications, especially in cardiovascular issues, significantly increasing morbidity and mortality. The pathophysiology of thrombosis disorder in HIV patients involves vascular, immune, and liver synthesis function problems, resulting in increased thrombogenesis. Clinical manifestations include deep vein thrombosis, pulmonary embolism, stroke, and myocardial infarct. Management is complex due to difficulties in diagnosis and increased therapeutic burden. Therapies involve using rosuvastatin and low-dose aspirin in managing inflammation and thrombosis. This article outlines the prevalence, pathophysiology, clinical manifestations, and management of thrombosis disorder in elderly patients with HIV infection.

Save to Mendeley


Keywords


HIV; thrombosis; elderly; inflammation; aging

Full Text:

PDF

References


Rasmussen LD, Engsig FN, Christensen H, Gerstoft J, Kronborg G, Pedersen C, et al. Risk of cerebrovascular events in persons with and without HIV: A Danish nationwide population-based cohort study. AIDS. 2011; 25 (13): 1637–46.

López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The Hallmarks of Aging. Cell. 2013; 153 (6): 1194-217.

Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J. Thromb. Thrombolysis. 2016; 41 (1): 3–14.

Kementerian Kesehatan Republik Indonesia. Laporan Eksekutif Perkembangan HIV AIDS dan Penyakit Infeksi Menular Seksual (PIMS) Triwulan IV tahun 2022. https://siha.kemkes.go.id/login_index.php (2022).

Nordell AD, McKenna M, Borges AH, Duprez D, Neuhaus J, Neaton JD. Severity of cardiovascular disease outcomes among patients with hiv is related to markers of inflammation and coagulation. J. Am. Heart Assoc. 2014; 3 (3): 1–10.

Wing EJ. The Aging Population with HIV Infection. Trans. Am. Clin. Climatol. Assoc. 2017; 128: 131–44.

Fitch KV, Feldpausch MN, Looby SED. Biomarkers and Clinical Indices of Aging with HIV. Interdiscip. Top. Gerontol. Geriatr. 2017; 42: 47–58.

Ford ES, Greenwald JH, Richterman AG, Rupert A, Dutcher L, Badralmaa Y, et al. Traditional risk factors and D-dimer predict incident cardiovascular disease events in chronic HIV infection. AIDS. 2010; 24 (10): 1509-17.

Iba T, Levy JH. Inflammation and thrombosis: roles of neutrophils, platelets and endothelial cells and their interactions in thrombus formation during sepsis. J. Thromb. Haemost. 2018; 16 (2): 231–41.

Maas C, Renne T. Coagulation factor XII in thrombosis and inflammation. Blood. 2018: 131 (17): 1903–09.

Funderburg NT. Markers of coagulation and inflammation often remain elevated in ART-treated HIV-infected patients. Curr. Opin. HIV AIDS. 2014: 9 (1): 80–6.

Stein JH, Klein MA, Bellehumeur JL, Wiebe DA, Otvos JD, Sosman JM. Use of human immunodeficiency virus-1 protease inhibitors is associated with atherogenic lipoprotein changes and endothelial dysfunction. Circulation. 2001; 104 (3): 257–62.

Martínez E, D'Albuquerque PM, Llibre JM, Gutierrez F, Podzamczer D, Antela A, et al. Changes in cardiovascular biomarkers in HIV-infected patients switching from ritonavir-boosted protease inhibitors to raltegravir. AIDS. 2012; 26 (18), 2315–26.

Mackman N. Role of tissue factor in hemostasis, thrombosis, and vascular development. Arterioscler. Thromb. Vasc. Biol. 2004; 24 (6), 1015–22.

Funderburg NT, Zidar DA, Shive C, Lioi A, Mudd J, Musselwhite LW, et al. Shared monocyte subset phenotypes in HIV-1 infection and in uninfected subjects with acute coronary syndrome. Blood. 2012; 120 (23): 4599–608.

Hsue PY, Hunt PW, Wu Y, Schnell A, Ho JE, Hatano H, et al. Association of abacavir and impaired endothelial function in treated and suppressed HIV-infected patients. AIDS. 2009; 23 (15): 2021–7.

Brenchley JM, Price DA, Schacker TW, Asher TE, Silvestri G, Rao S, et al. Microbial translocation is a cause of systemic immune activation in chronic HIV infection. Nat. Med. 2006; 12: 1365–71.

Nguyen N, Holodniy M. HIV infection in the elderly. Clin. Interv. Aging 2008; 3 (3), 453-72.

Nasi M, Biasi SD, Gibellini L, Bianchini E, Pecorini S, Bacca V, et al. Ageing and inflammation in patients with HIV infection. Clin. Exp. Immunol. 2017; 187 (1): 44–52.

Bibas M, Biava G, Antinori A. HIV-Associated Venous Thromboembolism. Mediterr. J. Hematol. Infect. Dis. 2011; 3 (1): e2011030.

Ismael S, Khan MM, Kumar P, Kodidela S, Mirzahosseini G, Kumar S, et al. HIV associated risk factors for ischemic stroke and future perspectives. International Journal of Molecular Sciences vol. 2020; 21 (15): 5306.

Metcalfe R, Schofield J, Milosevic C, Peters S. HIV diagnosis in older adults. Int. J. STD & AIDS. 2017; 28 (10): 1028–33.

Funderburg NT, Jiang Y, Debanne SM, Storer N, Labbato D, Clagett B, et al. Rosuvastatin Treatment Reduces Markers of Monocyte Activation in HIV-Infected Subjects on Antiretroviral Therapy. Clin. Infect. Dis. An Off. Publ. Infect. Dis. Soc. Am. 2014; 58 (4): 588-95.

O’Brien M, Montenont E, Hu L, Nardi MA, Valdes V, Merolla M, et al. Aspirin Attenuates Platelet Activation and Immune Activation in HIV-1-Infected Subjects on Antiretroviral Therapy: A Pilot Study. J. Acquir. Immune Defic. Syndr. 2013; 63 (3): 280-88.

Greene M, Justice AC, Lampiris HW, Valcour V. Management of Human Immunodeficiency Virus Infection in Advanced Age. JAMA. 2013; 309 (13): 1397-405.




DOI: https://doi.org/10.33508/jwmj.v6i4.6018

Refbacks

  • There are currently no refbacks.